New Jersey Limited-Benefit Plans

In 2002, the New Jersey legislature passed legislation which required individual market carriers to offer a limited-benefit plan, called Basic and Essential Health Care Services Plan (B&E).  The B&E plan provides for 90 days of hospitalizations, limited wellness and practitioner visit benefits, and some other limited benefits.  The plan does not include some benefits typically covered by commercial plans such as chemotherapy, outpatient drugs, prenatal care, speech and occupational therapy, home health, or hospice services. Carriers may offer riders that increase the benefits of B&E plans, for example, covering additional services.

Carriers are able to use modified community rating for B&E plans; however, all other products in New Jersey are pure community rated.   As of 2007, there were over 26,700 members enrolled in the B&E plan.